A sponsor may audit the manager once a year and pick the auditor
What the document says“The PDP sponsor shall have the right to select an auditor. The pharmacy benefit manager shall not impose any limitations on the selection of such auditor.”
At least once a year, at the sponsor's request, the manager must allow an audit of its compliance with the written agreement and the accuracy of what it reported. The sponsor picks the auditor and the manager may not limit that choice. The manager must give the auditor all records, data, contracts and other information needed, within six months of the audit's start, and must answer further requests within 30 days. It is responsible for information held by its affiliates.
What the document actually says“The PDP sponsor shall have the right to select an auditor. The pharmacy benefit manager shall not impose any limitations on the selection of such auditor.”
The plan picks who does the audit. The middleman may not put limits on that choice.
An audit is only worth as much as the auditor is free. If the middleman picked, it could pick a friendly one. The plan picks instead.
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